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The Age of the Superbug Is Here
- deleted 10y ago[deleted]
- livestockboy 10y agoeasy solution is to just heavily tax dairy, livestock and other industries that produce hundreds of billions of bacteria testing grounds (animals) per year at the same time using last-resport antibiotics to spur growth and reap profits. or give extreme tax benefits to those that don't use antibiotics.
- zdkl 10y agoYou think paying more for your food will make bacteria stop reacting to selective pressure? Or do you think we can stop relying on 'organic' food?(in the biochemical sense, not the hippie meaning) Either way I've got some bad news for you
- arethuza 10y agoIf the choice is cheap meat or antibiotics (and yes I know it's not quite that simple) then I'll take antibiotics.
- forgetsusername 10y ago>If the choice is cheap meat or antibiotics Easy to say when you're wealthy, no so much when you consider yourself healthy but poor.
- sten 10y agoMeat is a luxury.
- sageabilly 10y agoYup. I am an avid meat eater, love BBQ, all of the food I cook has meat in it- but I am absolutely aware that it is a luxury. I do my absolute best to buy higher quality meat as close to pasture raised as I can get... but I don't make that final leap to source out local farmers and buy directly from them to ensure that I know exactly how the meat I'm eating is raised. But at the end of the day, not everyone can afford organic pasture raised eggs at $7/dozen. And the problem is that we've all gotten so used to eggs at $0.50/dozen or chicken at $1/pound that I don't think society as a whole could deal with the cost of meat equalizing to reflect the true cost of non-factory farmed production.
- hx87 10y ago> I don't think society as a whole could deal with the cost of meat We certainly could if we had to, but so far we haven't had to.
- SolaceQuantum 10y agoIf meat is expensive you can go on to a largely vegetable and plant based diet. Meat is already more expensive than tofu and beans and lentils. And thanks to the Internet, it's now easy to pick up recipes and change ones diet with food from multiple cultures that don't use extensive amounts of meat.
- hx87 10y agoWhen I was poor, I didn't eat meat. If I am ever poor again I would go vegetarian. Cheap meat just isn't worth it.
- zdkl 10y agoThe cheap option is antibiotics, that's why we have this problem in hte first place! If you want the best of both worlds (limiting bacteria proliferation AND antibiotic use) the current methods for providing food at scale are impractical for many cost-related reasons.
- hx87 10y agoI thought the choice was between expensive meat or antibiotics, or between cheap meat and /no/ antibiotics?
- nebula 10y agoI can understand what he meant: Heavy use of antibiotics in diary and poultry industry is a significant factor contributing to drug resistant bacteria. In other words, these industries are actively providing the selection pressure you referring here.
- zdkl 10y agoWell the selection environment is a requirement to not getting sick from eating the products. You can't just have a nice chat with the microbe unions and ask them to behave and stay off the meat...
- livestockboy 10y ago> is a requirement to not getting sick from eating the products one gives antibiotics to one's thousands of chickens to spur growth (body growth - gaining mass), not to protect the consumer from disease. giving antibiotics to poultry extremely increases mass gains. post-slaughter processes add chemicals that keep meat from rotting, eradicating some of those living harmful bacteria that just so happen to turn flesh into unwanted dark piece of s+=t.
- zdkl 10y agoI entirely agree on your opinion of the antibiotic situation regarding large scale farming. The problem is that we could not substitute another method to produce enough food to me(e|a)t demand. If we want to keep eating we must have safe food, and to keep food safe in frankly hostile environments we need to treat it. Until we can do without what passes for modern industrialised food growing and processing, we'll need treatments and colorants so we can pretend this is 'regular' food.
- mercutio2 10y agoThere is no need to meet the current demand for meat. If meat was our only food source, then perhaps this syllogism you've drawn would be true. But in reality, meat is an inefficient form of producing food, with complements humans can easily shift to. So the way you get less antibiotic use in livestock in a capitalist decision market is by reducing the demand for livestock. Taxes do a great job at reducing demand.
- AlgorithmicTime 10y agoStrictly speaking, we could turn fossil fuels into food.
- restalis 10y agoI think limiting the means for gaining resistance should have been considered more seriously. For now, things are taken seriously only "when the shit hits the fan" and that in itself is a weakness that seemingly still affects us as species despite the numerous lessons that should have taught us the importance of prevention.
- deleted 10y ago[deleted]
- UweSchmidt 10y agoOr cut down on the meat and dairy consumption?
- edc117 10y agoTax increase = higher prices = how consumption is cut down. Unfortunately most people won't listen to appeals from the scientific community.
- ensignavenger 10y agoAny research you care to share to support your claims?
- livestockboy 10y agohttps://www.reddit.com/r/askscience/comments/4q920m/askscience_ama_series_we_are_sarah_fortune_and/ https://www.reddit.com/r/askscience/comments/4q920m/askscien... nice AMA from the experts directly. First answer: > First, a lot of antibiotic resistance appears to be driven by the agricultural use of antibiotics as growth enhancers. Thus, we can be savvy consumers and support and be willing to absorb the costs of the efforts to get antibiotics out of the meat industry. https://scholar.google.com/scholar?q=livestock+last-resort+antibiotics https://scholar.google.com/scholar?q=livestock+last-resort+a... Here's a nice batch of results. It's a well known problem, not some esoteric trivia. It is also the biggest cause of selective pressure, not antibacterial soaps or human medicine misuse of antibiotics.
- ensignavenger 10y agoCool, thanks! I did some looking into it, and it appears that as of 1 Jan 2017, in the US such uses of medically important antibiotics will be banned in the US (http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm507355.htm http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/uc...). The EU has had a ban since 2006. China and some other countries may still be a problem. Not sure how much meet the US/EU imports from those countries. With these bans in place, it doesn't seem necessary to implement a tax on their use. Perhaps a ban on importing meat that was produced using antibiotics for growth.
- gnashville 10y agoEasy in concept but the beef cartel would fight tooth and nail against something like this.
- arethuza 10y agoWe got a scare a couple of years back when our teenage son got an eye infection - the doctors and eye hospital went through five different antibiotics before finally finding something that fixed it, which was quite stressful. NB When you are warned not to wear contact lenses in swimming pools - take it seriously! We're almost certain that's how he got the problem.
- nkozyra 10y agoI've been wearing contacts most of my life and have never heard said warning. Given pools are typically fairly sterile, I'm not sure if understand it. Now freshwater lakes or oceans under certain conditions I could understand
- triplesec 10y agoSwimming pools are far from sterile. The chlorine and other additives serve to inhibit the growth of organisms, but with so many contaminating bodies in it, they are far from sterile. Some public pools, not assiduously managed, at the end of the day, take on more than the aroma of chlorine; but even those that don't are not free of bacteria and other interesting life.
- nkozyra 10y agoWell I specifically didn't say "sterile" but rather "fairly sterile" compared to other water sources. Edit: As a note to the pedants, of course sterile" is a binary, I used that casually to mean "less microbrial than a lot of the places where our eyes go." ;) <- right eye unfortunately hit the unsterile waters of a chlorinated pool.
- glormph 10y agoAs a former boss used to say, there is no "fairly sterile" just as there is no "fairly pregnant".
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- lossolo 10y agoThis is an amazing video[1] from Harvard Medical School released couple of days ago showing evolution of bacteria that evolve in 10 days to become resistant to antibiotics. [1] https://youtu.be/plVk4NVIUh8 https://youtu.be/plVk4NVIUh8
- kristofferR 10y agoPaper behind the experiment: http://science.sciencemag.org/content/353/6304/1147 http://science.sciencemag.org/content/353/6304/1147 http://kristofferR.com/files/baym2016.pdf http://kristofferR.com/files/baym2016.pdf
- DanBC 10y agoIt is amazing. They've been doing that experiment for a while now, so I hope the video makes people realise how serious it is. Here's a clip with a bit more information from the BBC Horizon popular science programme. http://v6.tinypic.com/player.swf?file=24goih4&s=6 http://v6.tinypic.com/player.swf?file=24goih4&s=6 (Sorry for the sub-optimal hosting, but YouTube's contentID blocks this clip.) One of the things they don't mention in that video is what the safe human dose of that antibiotic is. I'm not sure where on that slab the dose of antibiotics starts killing humans.
- maxerickson 10y agoYou can also have severe side effects that aren't lethal. Organ damage, hearing loss, stuff like that.
- arethuza 10y agoThat video is both fascinating and rather scary - as a colleague said watching over my shoulder "evolution in action".
- biesnecker 10y agoAmazing video. Question that comes to mind is how easy would it be to take the bacteria that make it to the center, and put them on a new plate with a different antibiotic in the same configuration, and then repeat until you've gone through all available antibiotics, then scoop that last batch up and do something really nasty with it? It must be harder than it seems, because otherwise why do terrorists and the like even bother with (seemingly much harder to obtain, though admittedly flashier) chemical and nuclear weapons?
- middlef 10y agoGood. Too many of us around. Good riddance.
- rhodrid 10y agoIt is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body. - ALEXANDER FLEMING, Nobel Lecture, December 11, 1945
- ddlatham 10y agoSounds a lot like live virus vaccines introduced to humans. Weak enough not to kill us and then we develop resistance. Improper dosage of antibiotics is like 'vaccinating' the microbes.
- mattnewton 10y agoSimilar, yes. It works through good old natural selection of generations, just on a faster scale. I enjoyed this visualizable antibiotic resistance happening. http://www.cnn.com/2016/09/08/health/giant-petri-dish-antibiotic-resistance/index.html http://www.cnn.com/2016/09/08/health/giant-petri-dish-antibi...
- spiegeldom 10y agoIt's all a lie. Yesterday Mark Zuckerberg told all deceases will be cured till 2100.
- middlef 10y agossh - if you don't buy the HN optimistic tech-will-cure-all BS they will downvote you (shaking with terror).
- naz 10y agoVery naive question: won't bacteria lose their resistance after a while? What if we cycle certain antibiotics on an annual basis? When we reintroduce them, they'll be more powerful. Right?
- strebler 10y agoI'm not sure, but that sounds like it might work. The real problem is: good luck getting all hospitals in the world to agree on a rotated schedule of which antibiotics to use / not use and when.
- crimsonalucard 10y agoWe are not enforcing a rotating schedule but hospitals are already naturally rotating antibiotics in response to resistance. Once penicillin was lost we switched to another antibiotic. The problem is that we don't have enough classes of antibiotics restart the cycle. It takes way longer for bacteria to lose resistance than for bacteria to gain resistance.
- simonbarker87 10y agoI was chatting to doctor friend recently who has a masters in this area and he said that in theory yes but it would likely require the bacteria to have a reason to loose the mutation that caused the resistance in the first place so there is no guarantee.
- crimsonalucard 10y agoYour doctor friend is incorrect. Unused traits will be lost eventually through the accumulation of random mutations. In order for a trait to form and be stable in an organism, selection pressure must not just be applied... it must be maintained. This backwards process is actually observable. Many fish living in underground caves have lost their eyes through evolution. While eyes don't aid a fish in surviving in the dark, they certainly don't hinder the fish from surviving either... Yet cave fish have lost their eyes despite the lack of negative selection pressure.
- ocschwar 10y agoAs per prior stories, let's all take a knee in thanks to our political system for trying literally to criminalize research into emerging superbugs: https://news.ycombinator.com/item?id=12444664 https://news.ycombinator.com/item?id=12444664
- TempleOS 10y agoSatan's Jedi mind tricks can't touch me. God says... rebates humanitarians Dixieland crybabies newer washstand reprove gruel alacrity's exigent Chan's Catt Virgo's exclaim crush's rules noodling European's corned Tamil's holiness experiment agonize tzar pointing Aleut voids threesomes staffer's sugaring floods plunge's
- DonaldFisk 10y agoThe article mentions phage therapy in passing, and links to this Nature article: http://www.nature.com/news/phage-therapy-gets-revitalized-1.15348 http://www.nature.com/news/phage-therapy-gets-revitalized-1.... The Nature article hints that the main barrier to adoption is that it's difficult to for pharmaceutical companies to make a profit out of phage therapy: the cure is entirely natural, bacteriophage are the most common organisms on the planet, they reproduce very quickly, and evolve to overcome bacterial resistance.
- DiffEq 10y agoYou used the word "evolve" - I don't think this means what you think it means. Evolving means that positive mutations are occurring that assist these organisms; what is really happening is Natural Selection; where already present genetic capabilities are being favored and those populations are thus surviving.
- barrkel 10y agoMutation + selection = evolution. Evolution doesn't necessarily mean positive mutations that assist. See http://evolution.berkeley.edu/evolibrary/misconceptions_faq.php#a3 http://evolution.berkeley.edu/evolibrary/misconceptions_faq....
- DonaldFisk 10y agoMutations occur in bacteriophage. Those mutant bacteriophage which can attack previously resistant bacteria are then selected for and become more prevalent.
- DiffEq 10y agoYour assertion has never been observed with any certainty that could withstand normal scientific inquiry; not even this experiment gives such certainty: https://en.wikipedia.org/wiki/E._coli_long-term_evolution_experiment https://en.wikipedia.org/wiki/E._coli_long-term_evolution_ex...
- lr4444lr 10y agoIt gives one pause to reconsider the social movement to get more people into dense "smart" cities.
- jcfrei 10y ago"Superbugs" are most prevalent in hospitals.
- tombert 10y agoThere's a pretty good Frontline about this...I didn't see this fact listed in the article, but another huge problem is that it's generally not profitable for big medicine corporations to research new antibiotics, which means that for the time-being, we're stuck with our current regime.
- tremon 10y agoIt wasn't profitable to research the old antibiotics either. They were developed with government money.
- Fomite 10y agoThere is active research funded by large pharmaceutical companies in developing new antibiotics. Merck bought Cubist Pharmaceuticals for a reason.
- radus 10y agoMerck followed the purchase with firing a large chunk of Cubist's researchers. It's more likely that they purchased Cubist for Dapto, a proven winner and billion dollar drug, and maybe for their pipeline. I wouldn't hold my breath for Merck to follow through on the research beyond trawling through whatever Cubist had in development already.
- Fomite 10y ago"Merck bought a company for their already successful antibiotic and the others they had in the pipeline" hardly undermines the notion that there's still money in antibiotic development. And they're still funding studies for Fidaxomicin.
- pdabbadabba 10y agoI find this implausible. Surely pharmaceutical companies are as aware as anyone of the growing antibiotic-resistance problem and know that there will likely be a return on their investments in new antibiotic research. Sure, these companies sometimes exhibit a bias towards short-term gains, but they also aren't run by morons. And if they are run by morons, I see some great start-up opportunities...
- rm2889 10y agoI live in India and despite some improvements, the level of antibiotic abuse here is shocking. They're available over the counter and people self-medicate with antibiotics all the time. The attitude is, "if my sore throat doesn't go away in a couple of days, its time to take antibiotics. No point in going to the doc coz they'll prescribe antibiotics too and this way I save money." People self-medicating on antibiotics end up taking an incomplete dose without fully understanding the implications. This has lead to the rise of superbugs like https://en.wikipedia.org/wiki/New_Delhi_metallo-beta-lactamase_1 https://en.wikipedia.org/wiki/New_Delhi_metallo-beta-lactama...
- rufius 10y agoI'd imagine it's not much different in Central and South America based on my travels. You can walk into any pharmacy and show them the word "amoxicillin" and they'll give you a 2 week course. Edit: a word
- aquiles 10y agoit depends. i live in an okay-ish part of south america and if a pharmacy gives you antibiotics without prescription they can get arrested, so most don't do it.
- senorjazz 10y agoCan confirm South America.
- cesarbs 10y agoIt used to be like that in Brazil, but in recent years Anvisa (the Brazilian equivalent of the FDA) tightened policy on this and now people can only buy antibiotics with a prescription. BTW, in my experience Brazilian doctors prescribe antibiotics a lot less than American doctors.
- robbiep 10y agoEven the EU is bad - Spain and Portugal allow OTC antibiotics (along with many Asian countries)
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- merraksh 10y agoRelated: has videos with bacteria gradually developing resistance to increasing concentrations of antibiotic. http://www.vox.com/2016/9/8/12852924/evolution-bacteria-timelapse-video-mega-harvard http://www.vox.com/2016/9/8/12852924/evolution-bacteria-time...
- uptown 10y agoThe antidote to overprescription of antibiotics is to be able to get accurate test results to determine what to treat rather than throwing antibiotics at every problem. This company is working on products which dramatically decrease testing times to the degree that you can have actionable information before prescribing antibiotics: Among some of the advancements: * Group B Strep results under one hour (traditionally 48-72 hours) * Salmonella results in 30 minutes (traditionally 24 hours) * Listeria results in 5 hours (traditionally 18 - 24 hours) http://nanologix.com/test_results.html http://nanologix.com/test_results.html
- darawk 10y agoI spoke to an MD/biochemist friend of mine about this issue recently, and was told that this really isn't that big a deal. Specifically that antibiotic resistance is usually a self-limiting trait, so bacteria that evolve that capability will quickly lose it when no longer in a hostile environment. So these 'superbugs' can be an issue in particular settings, like hospitals, but are unlikely to ever produce major global catastrophes, or spread much beyond those limited environments. Can anyone else with more knowledge of this confirm/refute this perspective? EDIT: I should point out he wasn't saying it was a total non-issue. Just that some of the fear-mongering about global pandemics and such was completely unfounded.
- bitwize 10y agoAll of which would be true -- in an environment where antibiotics weren't being pumped into battery-farmed livestock. But we don't live in that world.
- imaginenore 10y agoI think he is wrong. He have all kinds of antibiotic-resistant diseases in the wild, and so we have to introduce new antibiotics all the time.
- tedunangst 10y agoI've seen very little discussion of this. Is antibiotic resistant (proof?) TB in 2016 deadlier than TB without antibiotics in 1916? That seems extremely unlikely, but pop news coverage basically makes it sound like we're all going to die.
- robbiep 10y agoYou can have TB without having virulent TB. In fact, in western countries, if we discover infection we treat. If you have TB, your risk of becoming symptomatic is only about 1% per year, however you are potentially contagious the entire time. So in the health community we conduct TB screening, and most migrants are required to either show evidence of BCG status, or a series of chest x-rays often combined with the results of a Mantoux test. A friend of mine, an emergency trainee, recently changed hospitals and had to have another Mantoux test. He lived in shanghai as a kid and would have been exposed in some manner, even though his body either cleared it or it is long dormant (his CXRs are clear). NSW health policy is that he needs 6 months of a course of antibiotics to ensure it is not latent in him. The same approach is taken to would be migrants. So you see, with tb the issue is not so much virulence, but our ability to control its spread in the community and prevent a potential pandemic of XDR TB, which all of a sudden would have TB as big of a public health threat as it was 50 years ago
- Nano2rad 10y agoAntibiotics are used as growth factor in chicken. Many are growthfactors in humans also. There could be some way to fight antibiotic resistance considering this fact.
- mataug 10y agoEverytime we consider something to be a silver bullet we end up in a mess such as this. We are truly victims of our own success.
- roywiggins 10y agoWorst case scenario we end up with no working antibiotics. This is no worse than the pre-penicillin era. We haven't hurt ourselves by developing antibiotics.
- partycoder 10y agoHospitals give a wide range of antibiotics to people once they're admitted. Since after admitting someone they're legally responsible for their health.
- YeGoblynQueenne 10y agoOh, the UN is on this? Right, we're screwed. Seriously though, we can forget about getting 7 billion people to use antibiotics safely. Really- forget about it. Not even education helps- after all it's doctors and pharmacists who are primarily responsible for this mess we're in [1]. Our only chance is to find some other way to deal with bacteria -perhaps that phage therapy thing- otherwise we may as well just accept that X million people will die every year because of bacterial infections. Not to mention, of all the conditions that might be safe to treat given antibiotics, but not without them (you know, open heart surgery, brain surgery, that sort of thing). [1] Here's a childhood memory: my family doctor telling me I have a viral infection ... and prescribing antibiotics. Almost every year until I was 18 and stopped taking the damn things on my own, for entirely irrelevant reasons (I thought they were making me worse) (I got better).
- deleted 10y ago[deleted]